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Abstract. Rosmond R, Wallerius S, Wanger P, Martin L, Holm G, Björntorp P (The Cardiovascular Institute, Sahlgrenska University Hospital, Göteborg; and Huddinge University Hospital, Huddinge; Sweden). A 5-year follow-up study of disease incidence in men with an abnormal hormone pattern. J Intern Med 2003; 254: 386-390.Objectives. Previous studies have suggested that abnormal levels of cortisol and testosterone might increase the risk of serious somatic diseases. To test this hypothesis, we conducted a 5-year follow-up study in middle-aged men. Methods. A population-based cohort study conducted in 1995 amongst 141 Swedish men born in 1944, in whom a clinical examination supplemented by medical history aimed to disclose the presence of cardiovascular disease (CVD) (myocardial infarction, angina pectoris, stroke), type 2 diabetes and hypertension were performed at baseline and at follow-up in the year 2000. In addition, salivary cortisol levels were measured repeatedly over the day. Serum testosterone concentrations were also determined. Using the baseline data, an algorithm was constructed, which classified the secretion pattern of cortisol and testosterone from each individual as being normal or abnormal. Results. By the end of follow-up, men with an abnormal hormone secretion pattern (n ¼ 73) had elevated mean arterial pressure (P ¼ 0.003), fasting insulin (P ¼ 0.009) and insulin : glucose ratio (P ¼ 0.005) compared with men with a normal secretion pattern (n ¼ 68). Body mass index, waist circumference, and waist : hip ratio were significantly elevated in both groups. However, the 5-year incidence of CVD, type 2 diabetes, and hypertension were significantly higher (P < 0.001) in men with an abnormal neuroendocrine secretory pattern compared to men with a normal pattern. Conclusions. These data suggest that an abnormal neuroendocrine secretory pattern is prospectively associated with an increased incidence of cardiovascular-related events and type 2 diabetes.

Background: Support from the family positively affects self-management, patient outcomes and the incidence of hospitalizations among patients with heart failure (HF). To involve family members in HF care is thus valuable for the patients. Registered nurses (RNs) frequently meet family members to patients with HF and the quality of these encounters are likely to be influenced by the attitudes RNs hold toward families. Aims: To explore RNs' attitudes toward the importance of families' involvement in HF nursing care and to identify factors that predict the most supportive attitudes. Methods: Cross-sectional, multicentre websurvey study. A sample of 303 RNs from 47 hospitals and 30 primary health care centres (PHCC) completed the instrument Families' Importance in Nursing Care -Nurses' Attitudes. Results: Overall, RNs were supportive of families' involvement. Nonetheless, attitudes toward inviting families to actively take part in HF nursing care and involve families in planning of care were less supportive. Factors predicting the most supportive attitudes were to work in a PHCC, a HF clinic, a workplace with a general approach toward families, to have a postgraduate specialization, education in cardiac and or HF nursing care, and a competence to work with families. Conclusions: Experienced RNs in HF nursing care can be encouraged to mentor their younger and less experienced colleagues to strengthen their supportive attitudes toward families. RNs who have designated consultation time with patients and families, as in a nurse-led HF clinic, may have the most favourable condition for implementing a more supportive approach to families.

Information and communication technology (ICT) has increased in importance and facilitates participation in several life areas throughout society. However, young adults with mild to moderate intellectual disability make less use ICT than the general population. Disability services staff play a central role in supporting and enabling service users in daily life, and their perceptions of ICT are important to their role in service provision. The aim of the study is to describe staff perceptions of the role of ICT and how it affects daily life in young adults with mild to moderate intellectual disability living in residential homes. Focus group interviews and individual interviews were conducted with staff working in residential homes in which young adults with mild to moderate intellectual disability live. All materials were transcribed verbatim and analyzed using latent content analysis. Staff perceived ICT and, more specifically, the Internet as being supportive of both daily life and social relationships of these young adults, but they also viewed ICT as posing social risks. Perceptions of and support for ICT were related to staff perceptions about what is appropriate and manageable in relation to an individual resident's functioning level. Staff members also considered the views of parents about appropriate content when providing support. Staff in residential homes for young adults with mild to moderate intellectual disability use their implicit moral judgment about the use of ICT by residents. Their enablement of and support for ICT are not primarily based on the service user's wishes or interests. This finding implies a risk that the organization of a conflict‐free service provision is a higher priority than service users' participation in social life.

Young adults with mild-to-moderate ID use ICT in their daily life. The social care context needs to be further investigated due to its influence on the young adults' access to ICT and need of support.